by Robin R. Roach, MPH, EdD, RD Minority Nurse Writer
Name: Jacqueline Daughtry, LDN, RD
education: Bachelor of Science title: Clinical Dietician workplace: The Regional Medical Center location: Memphis, Tenn.
Jacqueline Daughtry grew up in Montego Bay, Jamaica, but she moved to the United States to pursue a career as a cosmetologist. After 17 years in cosmetology, however, Daughtry decided to pursue a second career. Considering her family commitments and her interest in medicine, she chose to complete a university degree in dietetics. After graduating, Daughtry was readily accepted into an accredited dietetic internship program. Now, as a clinical dietitian, she allowed me to spend the day with her at the Regional Medical Center in Memphis, Tenn., in order to present to the readers of Diversity: Allied Health Careers just what it takes to be a clinical dietitian.
Daughtry is one of six clinical dietitians in food and nutrition services at the Regional Medical Center. Located in downtown Memphis, adjacent to The University of Tennessee Medical School, the 350-bed, state-funded hospital is home to multiple Centers of Excellence including the Burn Center, High-Risk Obstetrics, Newborn Center, Elvis Presley Memorial Trauma Center and Wound Care Center.
According to Daughtry, her favorite aspect of her job is working with a diverse patient population that has a high acuity level. She also likes being part of a medical care team but appreciates the autonomy she has in managing her patients' nutritional needs. Daughtry enjoys working in a teaching hospital and interacting with allied health and medical students.
Characteristics that help Daughtry excel as a dietitian include her organizational skills, ability to multitask, positive attitude, flexibility and interpersonal skills. She'll quickly tell you that the rewards of her job outweigh any negative aspects. Daughtry loves teaching patients why it is important to make specific dietary choices. She promotes the teaching philosophy of "meeting the patient where they are."
Many opportunities are possible for Daughtry as a registered dietitian. In the future, she foresees completing a master's degree to become a clinical nutrition manager or education coordinator.
8:00 a.m. In any given workday, Daughtry is responsible for the nutritional care of patients in the medical-surgical, rehabilitation, obstetric-antepartum, postpartum and progressive care units. Each morning, in her office, she plans and organizes her day by first reviewing her computer printouts. She checks the printouts to screen for albumin levels, MID ordered consults, surgery patients, modified diet orders and nutrient/drug interactions.
At her desk with printouts in hand, Daughtry eats a bowl of instant oatmeal and makes notes about three patients with albumin levels suggestive of moderate to high nutritional risk, a new admit over 65 years of age who is scheduled for surgery, an anteparturn patient under 17 years of age, a postpartum patient with a two gram sodium diet order and three medical dietician consults. Over the course of the day, Daughtry will interact with patients from 13 to 92 years of age.
9:00 a.m. Daughtry's first stop is at the newly redone 20-bed Rehabilitation Hospital of Memphis that is located within the Regional Medical Center. She is involved in the discharge planning of rehab residents each week. She evaluates tube feedings and monitors weight, nutritional lab data and dietary intake of the residents. Daughtry has MD approval to write nutrition orders as needed. Today, she reviews lab data on the unit computer and checks the medical charts of three residents. She visits a 92-year-old new admit with cardiovascular disease who also has aphasia. Daughtry notes her breakfast tray, asks about her food preferences and checks her weight. After visiting a patient who has been in the hospital nine days and a 17year-old patient, Daughtry enters nutritional progress notes in their charts. Daughtry also interacts with the nursing staff and the nurse manager.
At the Obstetrics-Postpartum, Unit, a consultation has been ordered for a postpartum mom who is considering breastfeeding. Daughtry reviews her chart and checks her current lab data. She was admiitted with preeclampsia and has high blood pressure and,an elevated albumin. A review of her medications, unfortunately, indicates that she should not breastfeed. Daughtry discusses infant feeding options with the mother. The new mom seems relieved, confident and appreciative of having the facts to guide her in feeding her new baby.
Daughtry's pager rings. She wears a pager at all times while at work. An RN is requesting diabetic nutrition education materials for her nursing students. Daughtry encourages her to send the students to the patient diabetic education classes offered today to learn about the diabetic diet. They agree this will be more effective than just providing the diabetic nutrition handouts.
At the general ICU, the dietician is on vacation; so Daughtry checks on a consult to evaluate a tube-feeding regimen. She is pleased that another registered dietician has already: responded to the consult. Having the ability to multitask is an important part of the job. On the
unit, Daughtry takes the opportunity to interact with the speech therapist about a mutual patient. Daughtry is a member of the hospital dysphagia team and works closely with the speech therapist.
Back in the nutrition office, Daughtry checks to see if any other consults have been ordered. She typically eats lunch at her desk while completing paperwork. Tomorrow afternoon she is invited to present a nutrition education program for a third grade class of about 80 children. Community outreach is valued by the hospital
administration, so Daughtry, spends some time preparing for this presentation during her lunchtime. Daughtry also volunteered and was selected to serve as a professional mentor for minority students majoring in dietetics at The University of Memphis.
The Progressive Care Unit is a 16 bed step-down unit from ICU. Daughtry is responsible for eight of the beds there. She checks the recent labs on her patients and the Admission Health Assessment Form for a new patient. Although the new admit is at low nutritional risk, he is on a two gram sodium diet. He is coherent and complaining that he did not get any meat for breakfast. Daughtry talks with him about his dietary restrictions. They determine that he wants more food. Daughtry decides it would not be appropriate to send him low sodium bacon since it would not be available at the residential facility where he resides. Instead she decided to provide larger servings of his favorite breakfast cereals and will monitor whether or not these larger servings satisfy him in the future. Daughtry uses the hospital meals as educational tools whenever possible. She fills out the appropriate charts on this patient.
Back at the Medical-Surgical Unit, the nurse manager talks with Daughtry about dietary problems she is having following removal of her gallbladder. After a few questions Daughrty provides her with several suggestions that are well received and appreciated. Unit tabs are checked. A patient's low albumin is determined not
to be nutrition-related. A follow-up visit with a diabetic patient allows Daughtry to clarify some information and respond to dietary questions. She completes charts on several patients.
Daughtry provides dietary instruction for a patient with cirrhosis who is being discharged. She also visits a patient scheduled for testing who has to restrict red food coloring.
In Daughtry's office, she interacts with other registered dieticians about the Performance Improvement Project for Clinical Nutrition that is ongoing. She completes her log of activities for the day and will be able to leave work by 4:30 p.m. today. She works Monday through Friday and every sixth weekend. A perk of her job is that she has "flex time." She may need to come in early or leave early one day, This enables her to balance personal and professional commitments. She is usually able to arrange her schedule so she can attend her children's school programs, make dentist appointments, teach an aerobics class for employees and more.